A number of reports have described the development of malignancy in association with congenital lung cysts.I -'8 Adenocarcinoma is the most common type of tumour, often of bronchioloalveolar pattem, but squamous cell carcinoma has also been reported.7'8 Squamous metaplasia of the lining epithelium of congenital cysts has been implicated as the precursor lesion in the development of squamous cell carcinoma in some cases,9 but the mechanisms implicated in the development of other tumour types are not clear.We describe two cases of congenital adenomatoid malformation in children in which mucinous epithelium lining parts of the cysts showed hyperplasia and intra-alveolar extension. These cases are compared with a case of bronchioloalveolar carcinoma in an adult associated with a long standing pulmonary cyst and similar mucous cell hyperplasia. We discuss the possible importance of this unusual hyperplasia. An 18 year old male athlete presented with slight haemoptysis and impairment of his exercise tolerance. A chest radiograph showed a left sided apical cyst, which was excised with a wedge of surrounding lung.Examination of the resected specimen showed a 6-5 cm diameter cyst with a trabeculated inner surface; white nodules, measuring up to 04 cm in diameter, were found in the adjacent lung. During investigation for isolated pulmonary valve stenosis a 6 month old boy was found to have multiple cysts within the right lower lobe, which compressed the mediastinum. A right lower lobectomy was performed. Examination of the resected lobe showed that it was largely replaced by multiloculated cysts, measuring from 0 5 to 4 cm in diameter, which communicated with the bronchi. There was a thin peripheral rim of unaffected lung.Accepted br publication 22 December 1986 All the specimens were fixed in formalin, those from cases 1 and 2 being inflated through the lobar bronchus. Representative blocks were taken from the specimens, and sections were stained by haematoxylin and eosin and elastic van Gieson. Mucin was identified by periodic acid Schiff and alcian blue high iron diamine stains.
Compliance measurements of 53 long saphenous veins before femorodistal bypass have been performed using a duplex scanner with venous occlusion for distension. These have been compared with the histological features of the veins. There was significantly more moderate or severe focal hyperplasia and circular muscle hypertrophy in distal long saphenous vein than in its proximal counterpart (P < 0.01 and P < 0.05 respectively). The mean (95 per cent confidence interval) compliance of distal vein with moderate or severe hyperplasia was 0.16 (0.13-0.19) compared with 0.29 (0.22-0.36) for that with no, minimal or mild hyperplasia (P = 0.001). The mean compliance of distal vein with moderate or severe muscle hypertrophy was 0.19 (0.17-0.21) and of vein with no, minimal or mild hypertrophy 0.25 (0.21-0.29) (P = 0.14). The mean lowest compliance in seven patients who developed stenosis was 0.10 (0.07-0.13) compared with 0.21 (0.16-0.26) in the rest (P < 0.001). Preoperative measurement of vein compliance can be used to identify vein with marked pre-existing intimal hyperplasia and as a predictor of future graft stenosis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.